Alvarez M, González R, Briceño I, Cofre C, Labarca J, Vial P, García P
Departamento de Gastroenterología, Unidad Docente Asociada de Laboratorios Clínicos, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Rev Med Chil. 2001 Jun;129(6):620-5.
The clinical parameters for the suspicion of Clostridium difficile infections, namely the use of antimicrobials and diarrhea, have a low predictive value for the diagnosis.
To search other clinical variables and determine a clinical prediction model for (Clostridium difficile diarrhea.
All patients to whom a Clostridium difficile study was requested, were prospectively studied during 5 months. Clinical variables of these patients were registered. The diagnosis of Clostridium difficile was done using the cytotoxicity test in fibroblast cultures.
Ninety two patients were analyzed and in 26, the diagnosis of Clostridium difficile was confirmed. A logistic regression model disclosed an age over 60 years old, the presence of mucus in the stools and a temperature over 37.8 degrees C in the previous 24 h, as significant predictors of the infection. The correlation of the model, between the predicted probability and the observed condition, was 81.5%.
The presence of the clinical variables identified in this study are associated with a high probability of an infection by Clostridium difficile in patients with diarrhea and the recent use of antimicrobials.
用于怀疑艰难梭菌感染的临床参数，即抗菌药物的使用和腹泻，对诊断的预测价值较低。
寻找其他临床变量并确定艰难梭菌腹泻的临床预测模型。
所有被要求进行艰难梭菌研究的患者，在5个月内进行前瞻性研究。记录这些患者的临床变量。采用成纤维细胞培养中的细胞毒性试验进行艰难梭菌的诊断。
分析了92例患者，其中26例确诊为艰难梭菌感染。逻辑回归模型显示，年龄超过60岁、粪便中存在黏液以及前24小时体温超过37.8℃是感染的重要预测因素。该模型的预测概率与观察到的情况之间的相关性为81.5%。
本研究确定的临床变量的存在与腹泻且近期使用过抗菌药物的患者发生艰难梭菌感染的高概率相关。
